The vaccine is highly effective at preventing the contagious disease, but people without immunity remain exposed and at risk.

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Chickenpox was once a rite of passage for most children, with its signature itchy red bumps and fever. While most patients completely recover in a week, the disease can be severe and sometimes life threatening. The introduction of the varicella vaccine in 1995 has made chickenpox relatively rare. The vaccine provides more than 95 percent protection against severe cases, according to the World Health Organization. But chickenpox still poses a serious threat, and some people remain especially at risk.

While the chickenpox vaccine is now included in routine childhood vaccinations, teenagers and adults born before the vaccination was released and who never contracted the disease are vulnerable to more severe forms of the virus. Chickenpox can be deadly even to healthy individuals. A 15-year-old Ohio girl with no underlying conditions died from complications of the virus in 2009, as reported this month in a case study from the Centers for Disease Control and Prevention.

The teenager, who was born the year before the chickenpox vaccine was introduced, serves as “a reminder of the importance of catch-up vaccination of older children and adolescents to prevent varicella and its serious complications later in life when disease can be more severe,” according to the CDC.

“It is likely that the death would have been prevented with prior vaccination,” said Kenneth Bromberg, MD, director of the Vaccine Research Center and chairman of pediatrics at the Brooklyn Hospital Center in New York City, on the day of the CDC release.

A study in the May issue of Pediatrics reports the vaccine is “very effective” at preventing the disease and that protection doesn't decrease over time. Before the vaccine was available, more than 90 percent of children contracted chickenpox before they were 20 years old and the disease caused around 100 deaths a year.

The vaccine has since led to a 95 percent decline in illnesses, hospitalizations and deaths in populations where vaccination is routine, according to the CDC.

When the vaccine was first introduced, doctors were unsure if it would provide immunity into adulthood. In the Pediatrics study, more than 7,000 children were first given the vaccine when they were 2 years old in 1995. Of those, 2,800 received booster vaccines 10 years later. Researchers then followed the subjects’ health for 14 years, looking for signs of chickenpox or shingles, another infection caused by the chickenpox virus, which typically affects older adults.

Just over 1,500 kids contracted chickenpox after the first dose, and no cases were documented after the second dose. Once the vaccine was introduced, the study noted the rate of the disease in children who received the vaccine was about 10 times lower than if had they not been vaccinated.

“This is a really good vaccine,” wrote the study’s lead author, Dr. Roger Baxter, co-director of the Vaccine Study Center at Kaiser Permanente in Oakland, Calif. One dose provides protection against most cases, while “the second dose just wipes it out.”

Currently, the CDC recommends all individuals get two doses of the vaccine. Children should get the first one between 12 and 15 months of age and a second when they’re between four and six years old.

But it’s important that teenagers and adults who were born before the vaccine still get vaccinated if they haven’t contracted the chickenpox.

“Because children are being routinely vaccinated in the U.S., the chance of being exposed to cases of chickenpox is decreasing,” said Sharon Humiston, MD, associate director for research at the Immunization Action Coalition and professor of pediatrics and University of Missouri, Kansas City. “For this reason, older children, adolescents, and adults who have not had chickenpox now have a greater chance of remaining susceptible, so they need to be vaccinated.”

The virus typically attacks children under the age of 15, according to the CDC. The chickenpox rash goes through three phases: first raised red bumps, then fluid-filled blisters that eventually break and form scabs. Typically the infection lasts about five to 10 days, and it’s highly contagious until all of the blisters scab over. Adult onset chickenpox has a higher risk of complications, including brain inflammation, bacterial infections of the skin, blood and bone infections.

Dr. Humiston said many of her medical students have never even seen a case of the chickenpox during their training. The drastic reduction of chickenpox-related hospitalizations and deaths is all “great news in a short time,” she said.

Still, Humiston stressed the importance of getting vaccinated, no matter your age. “People who first contract chickenpox as adults are more likely to become seriously ill and have disease complications than people who first contract chickenpox in childhood,” she said. “If you’re not already immune, get the vaccine.”

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